Addressing substance abuse among healthcare professionals in a tertiary healthcare facility in Nigeria: a case study of Nnamdi Azikiwe university teaching hospital

Background: The use of psychoactive substances is prevalent worldwide, including among healthcare workers whose well-being, productivity, and effectiveness in addressing substance addiction in patients and the wider community can be significantly impacted. However, the extent of substance misuse among healthcare professionals in Nigeria, with its substantial social and public health implications, remains poorly understood. This research focused on the prevalence, attitudes, substances used, and influencing factors regarding substance misuse among staff at Nnamdi Azikiwe university teaching hospital (NAUTH) in Nnewi. Methods: A descriptive cross-sectional study was conducted involving 194 healthcare workers, using a multi-stage sampling method. Data were collected via a semi-structured self-administered questionnaire and analyzed with SPSS version 20. Results were presented in tables, considering p values less than 0.05 as significant. Results: Of the 197 respondents, 63.5% were female and 36.5% male, spanning various professions including doctors, nurses, and other healthcare specialists. Notably, 66% of participants had used substances in their lifetime. Alcohol was the most commonly abused substance, with significant percentages of moderate and high-risk users. Socialization and peer pressure were identified as the predominant factors influencing substance use, with significant statistical associations found between substance use and variables such as profession, sex, and duration of practice. Conclusions: The study highlighted a considerable prevalence of alcohol use among healthcare workers, who generally held a moderate view towards substance misuse and identified socialization and peer pressure as key factors. These findings underscore the pressing need for targeted training and intervention strategies for substance addiction among healthcare workers in Nigeria.

Empleo empírico de cannabis para control del dolor crónico de origen musculoesquelético / Empirical use of cannabis to control chronic pain of musculoskeletal origin

Resumen: Introducción: La creciente aceptación de los cannabinoides con fines terapéuticos se ha vinculado a cambios en la legislación, alta prevalencia y control ineficaz de dolor crónico con analgésicos convencionales. Objetivo: Determinar la prevalencia del dolor crónico, la modalidad de tratamiento analgésico con terapias herbales (cannabis) en adultos del sureste de México. Material y métodos: Se efectuó un estudio transversal y etnográfico en 267 personas con dolor crónico y empleo regular de la herbolaria con fines analgésicos. Se efectuaron pruebas de hipótesis para evaluar diferencias entre valores promedio, edad e intensidad del dolor, comparándose el empleo de cannabis con el tipo de dolor, género, diagnósticos algológicos y comorbilidades. Resultados: Se observó asociación entre dolor crónico con: diabetes, hipertensión, neoplasias en mujeres, adultos mayores. El 46% de los participantes padecía osteoartritis y 20.9% presentaba otros diagnósticos. Las modalidades preferidas para la administración tópica de cannabis fueron tinturas en mezcal o en alcohol y, en menor proporción, macerados en aceites e inhalación. Conclusiones: Los hallazgos no permiten considerar a la cannabis como monoterapia para pacientes con dolor crónico. Sin embargo, ofrecen un campo promisorio en la búsqueda de alternativas analgésicas que eviten el consumo crónico de opiáceos o antiinflamatorios no esteroideos (AINE).

Abstract: Introduction: The increasing acceptance of cannabinoids for therapeutic purposes has been linked to changes in legislation, high prevalence and ineffective control of chronic pain with conventional analgesics. Objective: Determine the prevalence of chronic pain, the analgesic treatment modality with herbal therapies (cannabis) in adults in southeastern Mexico. Material and methods: A cross-sectional and ethnographic study was carried out on 267 people with chronic pain and regular use of herbal medicine for analgesic purposes. Hypothesis tests were carried out to evaluate differences between average values, age and pain intensity, comparing the use of cannabis with the type of pain, gender, algological diagnoses and comorbidities. Results: An association was observed between chronic pain: diabetes, hypertension, neoplasms in women, in older adults. 46% of the participants suffered from osteoarthritis and 20.9% had other diagnoses. The preferred modality for the topical administration of cannabis was tinctures in Mezcal or alcohol and to a lesser extent macerated in oils and inhalation. Conclusions: The findings do not allow cannabis to be considered as monotherapy for chronic pain in patients with chronic pain. However, they offer a promising field in the search for analgesic alternatives that avoid the chronic consumption of opiates or non-steroidal anti-inflammatory drugs (NSAIDs).

La marihuana de hoy no es la que fumaba tú abuela

Johnny Stack, como nos lo relata Isabella Backman, se inició en la marihuana en una fiesta de la escuela a sus 14 años, cuando apenas se había legalizado su uso medicinal en Colorado. Esa marihuana la había obtenido el hermano mayor de unos de sus amigos, quien tenía una tarjeta para marihuana medicinal. A los 19 años, después de 5 años de estar luchando contra adicción y psicosis, Johnny muere por suicidio. Tres días antes, nos dice Backman, le dijo a su madre que la marihuana le había arruinado su mente y su vida. Nunca se probó, a pesar de múltiples pruebas de laboratorio, que usara ninguna otra droga. (provisto por Infomedic International)

Johnny Stack, as Isabella Backman tells us, was introduced to marijuana at a school party when he was 14 years old, when its medical use had just been legalized in Colorado. That marijuana had been obtained by the older brother of one of her friends, who had a medical marijuana card. At 19, after five years of struggling with addiction and psychosis, Johnny died by suicide. Three days earlier, Backman tells us, he told his mother that marijuana had ruined his mind and his life. It was never proven, despite multiple lab tests, that he used any other drug. (provided by Infomedic International)

Autoestima y consumo de cannabis en adolescentes: Una revisión integrativa / Self-esteem and cannabis use in adolescents: An integrative review

Resumen Objetivo: Identificar la evidencia científica relacionada con la influencia que tiene la autoestima en el consumo de cannabis de los adolescentes. Materiales y método: Durante el periodo de febrero-abril de 2022 se realizó una revisión integrativa de la literatura científica publicada en los últimos diez años (2012-2022). Se utilizó la metodología de seis pasos propuesta por Toronto y Remington en los motores de búsqueda de la BVS, PubMed, TRIP y Dialnet, así como, en las bases de datos de Redalyc, Cochrane, EBSCOhost, Web of Science y CUIDEN. Se encontraron un total de 1,491 artículos, al aplicar criterios de inclusión y eliminación se contemplaron un total de diez estudios cuantitativos en la muestra final. Resultados: Se encontró que los adolescentes con baja autoestima están propensos a influencias que fomentan el inicio de consumo de cannabis. Al considerarse como una actitud positiva de la persona hacia sí misma, favorece el sentimiento de seguridad y regula la conducta mediante un proceso de autoevaluación, de modo que posibilita la adecuación de los adolescentes a su entorno. En este sentido se observaron tres categorías principales: variable moderadora en el consumo de cannabis; variable predictora del consumo de cannabis; y componente de intervención. Conclusiones: Se demostró el papel protector y predictivo de la autoestima para el consumo de cannabis en los adolescentes, asimismo, la detección temprana y las intervenciones dirigidas a mejorar las habilidades para la regulación de emociones influenciadas por factores cognitivos son efectivas en la promoción y prevención de consumo de cannabis en el adolescente.

Abstract Objective: To identify the scientific evidence related to the influence of self-esteem on adolescent cannabis use. Materials and method: During the period of february-april 2022, an integrative review of the scientific literature published in the last ten years (2012-2022) was carried out. The sixstep methodology proposed by Toronto and Remington was used in the BVS, PubMed, TRIP and Dialnet search engines, as well as in the Redalyc, Cochrane, EBSCOhost, Web of Science and CUIDEN databases. A total of 1,491 articles were found, when applying inclusion and elimination criteria, a total of ten quantitative studies were considered in the final sample. Results: It was found that adolescents with low self-esteem are prone to influences that encourage the initiation of cannabis use. When considered as a positive attitude of the person towards himself, it favors the feeling of security and regulates behavior through a process of self-evaluation, so that it enables adolescents to adapt to their environment. In this sense, three main categories were observed: moderator variable in cannabis use; predictor variable of cannabis use; and intervention component. Conclusions: The protective and predictive role of self-esteem for cannabis use in adolescents was demonstrated, likewise, early detection and interventions aimed at improving skills for the regulation of emotions influenced by cognitive factors are effective in the promotion and prevention of cannabis use in adolescents.

Analyzing the medical use of cannabis for cancer patients: a critical perspective

The utilization of cannabis in oncology presents a multifaceted approach to addressing the complex challenges associated with cancer treatment. With roots tracing back to ancient medicinal practices, cannabis contains numerous compounds, including cannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD), that interact with the body's endocannabinoid system. These interactions offer potential therapeutic benefits, ranging from antiemetic and analgesic effects to the inhibition of cancer growth processes. While clinical evidence supports the efficacy of cannabinoids in managing symptoms and enhancing the quality of life for cancer patients, caution is warranted due to potential interactions with conventional medications. Understanding the mechanisms of action, optimal administration routes, and potential side effects is crucial for integrating cannabis into personalized cancer care plans. By navigating these considerations thoughtfully, medical practitioners can harness the therapeutic potential of cannabis to complement traditional cancer treatments and improve patient outcomes in the field of oncology.

Sobre ativismos e conhecimentos: a experiência de associações canábicas no Brasil / On activism and knowledge: the experience of cannabis associations in Brazil

Resumo O surgimento de associações civis em prol da cannabis se iniciou na década de 2010. Diante da inércia do Estado, essas organizações têm atuado no acolhimento, apoio, informação, capacitação e facilitação do acesso de pacientes e familiares a medicamento produzido à base de maconha, substância proibida no Brasil. Este estudo visa analisar como o ativismo canábico promovido pelas associações brasileiras se fundamenta em conhecimentos científicos ou adquiridos pela vivência dos associados. A metodologia englobou entrevistas com participantes das associações ACuCa, Ama+me e Apepi e análise de conteúdo dos perfis dessas instituições no Instagram. Verificou-se que o ativismo canábico no Instagram apresenta semelhanças com aquele praticado presencialmente, no entanto, o ativismo nas mídias sociais prioriza a divulgação do conhecimento pela informação e capacitação de seus seguidores, tendo o cuidado de tratar o conteúdo para se adequar às diretrizes da plataforma. Além disso, as principais linhas de atuação do associativismo canábico (acolhimento e distribuição de óleos medicinais) aparecem de forma velada nas publicações, sendo que em sua maioria ocorrem em conversas privadas nos meios de comunicação com as associações.

Abstract The emergence of civil associations in favor of cannabis began in the 2010s. Faced with the inertia of the State, these organizations have acted in the reception, support, information, training, and facilitation of access for patients and their families to the medicine produced from marijuana, a prohibited substance in Brazil. This study aims to analyze how cannabis activism promoted by Brazilian associations is based on scientific knowledge or knowledge acquired through the experience of members. The methodology included interviews with participants from the ACuCa, Ama+me, and Apepi associations, as well as the Content Analysis of the profiles of these institutions on Instagram. It was found that cannabis activism on Instagram is similar to that practiced in person; however, activism on social media prioritizes the dissemination of knowledge through information and training of its followers, being careful to treat the content in order to suit the guidelines of the platform. In addition, the main lines of action of cannabis associations (reception and distribution of medicinal oils) appear in a veiled way in the publications, most of which occur through private conversations in the media with the associations.

Tensiones y diferencias entre un saber-hacer popular y el modo de producción de conocimiento biomédico: el caso de los usos terapéuticos del cannabis / Tensões e diferenças entre um saber-fazer popular e o modo de produzir conhecimento biomédico: o caso dos usos terapêuticos da cannabis / Tensions and differences between popular know-how and biomedical knowledge production: the case cannabis for therapeutic purposes

Resumen Aproximadamente a partir del año 2010, los usos terapéuticos del cannabis se han extendido en nuestras sociedades latinoamericanas. Dichas terapias se construyen mayormente en el ámbito doméstico y en redes por fuera de instituciones oficiales de salud. Así, la biomedicina tiende a subalternatizar cualquier saber-hacer alternativo al modelo médico hegemónico. Nuestro objetivo es describir cómo se produce saber-hacer popular en torno a los usos terapéuticos del cannabis, identificando las tensiones y diferencias con la biomedicina. Metodológicamente nos basamos en experiencias documentadas en investigaciones propias y de otres, para construir una descripción sobre ese saber-hacer popular en contraste con el biomédico. Nuestros resultados dan cuenta de las singularidades epistémicas, metodológicas y valorativas en la construcción de los usos terapéuticos del cannabis, acompañada de una negación autoridad epistémica y marginalización en la producción, circulación y reconocimiento sobre su valor terapéutico. Recurrimos al concepto de violencia epistémica como analizador para comprender dicho proceso violencia que en ocasiones puede abonar a una violencia institucional. Consideramos necesario visibilizar la violencia epistémica que impide el desarrollo de saberes, conocimientos y terapias alternativos que vienen a complementar y (re)crear, y no a reemplazar, formas de pensar e intervenir en el ámbito salud.

Resumo Aproximadamente a partir do ano de 2010, os usos terapêuticos da cannabis se difundiram em nossas sociedades latino-americanas. Essas terapias são construídas maioritariamente no âmbito doméstico e em redes fora das instituições oficiais de saúde. Assim, a biomedicina tende a subordinar qualquer saber-fazer alternativo ao modelo médico hegemônico. Nosso objetivo é descrever como se produz um saber-fazer popular sobre usos terapêuticos da cannabis, identificando as tensões e diferenças com a biomedicina. Metodologicamente, nos baseamos em experiências documentadas em pesquisas próprias e alheias, para construir uma descrição desse saber-fazer popular em contraste com o biomédico. Nossos resultados dão conta da singularidade das características epistêmicas, metodológicas e dos valores da construção de usos terapêuticos da cannabis, à qual é negada autoridade epistêmica e se atribui um papel marginal na produção, circulação e reconhecimento. Nesse sentido, recorremos ao conceito de violência epistêmica para compreender esse processo. Essa violência, além disso, às vezes pode contribuir para a violência institucional. Consideramos necessário dar visibilidade à violência epistêmica que impede o desenvolvimento de saberes alternativos, saberes e terapias que complementem e (re)criem, e não substituam, modos de pensar e intervir no campo da saúde.

Abstract Approximately since the year 2010, the therapeutic uses of cannabis have spread in our Latin American societies. These therapies are mostly built in domestic contexts and in networks apart of official health institutions. In this sense, biomedicine tends to subordinate any alternative know-how to the hegemonic medical model. Our objective is to describe how the popular know-how around therapeutic uses of cannabis is produced, identifying the tensions and differences with biomedicine. Methodologically, we build a description of this popular know-how, in contrast to biomedicine, based on experiences documented in previous research. Our results account for the uniqueness of the epistemic, methodological, and values characteristics of the construction of therapeutic uses of cannabis, for which epistemic authority is denied and a marginal role in the production, circulation, and recognition of its therapeutic value is assigned. We appeal to the concept of epistemic violence to understand this process. Moreover, this violence can sometimes contribute to institutional violence. We consider it necessary to make visible the epistemic violence that prevents the development of alternative knowledge and therapies that complement and (re)create, but not replace, ways of thinking and intervening in health issues.

Prevalencia de consumo de cocaína y cannabis en pacientes traumatizados ingresados a medicina intensiva / Prevalence of cocaine and cannabis use in trauma patients admitted to intensive care / Prevalência do uso de cocaína e canábis em doentes traumatizados internados em cuidados intensivos

Introducción: Las drogas psicoactivas constituyen un factor de riesgo para traumatismos graves ya que alteran el comportamiento y el nivel de conciencia. Objetivo: Conocer la prevalencia de traumatizados graves expuestos a cocaína y cannabis, perfil epidemiológico y comparar resultados según presencia de consumo. Metodología: Estudio observacional prospectivo realizado durante 12 meses entre mayo 2021 y abril 2022 en la unidad de cuidados intensivos del Hospital Maciel. Se incluyeron traumatizados graves ingresados a terapia intensiva en los cuales se realizó detección cualitativa de metabolitos de cocaína y cannabis en orina. Resultados: Se incluyeron 111 pacientes, 89% hombres, edad (media ± desvío) 32 ±11 años, Simplified Acute Physiology Score (SAPS III) 43 ±14, Injury Severity Score (ISS) 26 ±16, mortalidad 10 (9%). Se detectó consumo de cocaína en 62 (55,9%), cannabis en 72 (64,9%) y en 42 (37,8%) para ambas. Pacientes con screening positivo fueron más jóvenes (30,5 ±9,4 vs 40,6 ±16,7; p <0,02) y predominantemente hombres (86% vs 58%; p= 0,02). No se hallaron diferencias significativas con relación a mortalidad, necesidad o duración de ventilación mecánica y estadía. El despertar excitado en consumidores fue (53,3% vs 36,8%), la autoextubación (13,3% vs 7,7%), extubación fallida (4,8% vs 0%) y reintubación (12% vs 0%), diferencias estadísticamente no significativas. Conclusiones: La prevalencia de consumo de cocaína y cannabis en pacientes traumatizados que ingresaron a nuestra unidad de medicina intensiva es elevada. El perfil epidemiológico corresponde a pacientes jóvenes, de sexo masculino. No se encontró mayor mortalidad, complicaciones o mayor estadía en terapia intensiva.

Introduction: Psychoactive drugs constitute a risk factor for severe trauma as they alter behavior and consciousness levels. Objective: To determine the prevalence of severely traumatized patients exposed to cocaine and cannabis, assess the epidemiological profile, and compare outcomes based on substance use. Methodology: Prospective observational study conducted over 12 months between May 2021 and April 2022 in the intensive care unit of Hospital Maciel. Severely traumatized patients admitted to intensive care underwent qualitative detection of cocaine and cannabis metabolites in urine. Results: A total of 111 patients were included, 89% were male, mean age (± standard deviation) 32 ± 11 years, Simplified Acute Physiology Score (SAPS III) 43 ± 14, Injury Severity Score (ISS) 26 ± 16, mortality 10 (9%). Cocaine use was detected in 62 (55,9%) patients, cannabis in 72 (64,9%), and both in 42 (37,8%). Patients with positive screening were younger (30,5 ± 9,4 vs. 40,6 ± 16,7; p < 0,02) and predominantly male (86% vs. 58%; p = 0,02). No significant differences were found in terms of mortality, need or duration of mechanical ventilation, and ICU length of stay. Agitated awakening was observed in users (53,3% vs. 36,8%), self-extubation (13,3% vs. 7,7%), failed extubation (4,8% vs. 0%), and reintubation (12% vs. 0%), with statistically non-significant differences. Conclusions: The prevalence of cocaine and cannabis use among traumatized patients admitted to our intensive care unit is high. The epidemiological profile corresponds to young male patients. There was no increased mortality, complications, or prolonged ICU stay observed.

Introdução: Drogas psicoativas constituem um fator de risco para trauma grave, pois alteram o comportamento e o nível de consciência. Objetivo: Determinar a prevalência de pacientes gravemente traumatizados expostos a cocaína e cannabis, avaliar o perfil epidemiológico e comparar os resultados com base no uso dessas substâncias. Metodologia: Estudo observacional prospectivo realizado ao longo de 12 meses entre maio de 2021 e abril de 2022 na unidade de terapia intensiva do Hospital Maciel. Pacientes gravemente traumatizados admitidos na UTI foram submetidos à detecção qualitativa de metabólitos de cocaína e cannabis na urina. Resultados: Um total de 111 pacientes foram incluídos, 89% eram homens, idade média (± desvio padrão) de 32 ± 11 anos, Simplified Acute Physiology Score (SAPS III) de 43 ± 14, Injury Severity Score (ISS) de 26 ± 16, mortalidade de 10 (9%). O consumo de cocaína foi detectado em 62 (55,9%) pacientes, cannabis em 72 (64,9%), e ambos em 42 (37,8%). Pacientes com resultado positivo no rastreamento eram mais jovens (30,5 ± 9,4 vs. 40,6 ± 16,7; p < 0,02) e predominantemente do sexo masculino (86% vs. 58%; p = 0,02). Não foram encontradas diferenças significativas em relação à mortalidade, necessidade ou duração da ventilação mecânica e tempo de internação na UTI. Um despertar agitado foi observado entre os usuários (53,3% vs. 36,8%), autoextubação (13,3% vs. 7,7%), falha na extubação (4,8% vs. 0%) e reintubação (12% vs. 0%), com diferenças estatisticamente não significativas. Conclusões: A prevalência de consumo de cocaína e cannabis entre pacientes traumatizados admitidos em nossa unidade de terapia intensiva é elevada. O perfil epidemiológico corresponde a pacientes jovens do sexo masculino. Não houve aumento da mortalidade, complicações ou prolongamento da estadia na UTI observados.

Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind, and placebo-controlled clinical trial

Abstract Objective Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction and by restricted and repetitive patterns of behavior. Some studies have shown that substances derived from Cannabis sativa improve the quality of life of children with ASD without causing serious adverse effects, thus providing an alternative therapeutic option. The objective of this study was to evaluate the efficacy and safety of a cannabis extract rich in cannabidiol (CBD) in children with ASD. Methods In this randomized, double-blind, placebo-controlled clinical trial, 60 children, aged from 5 to 11 years, were selected and divided into two groups: the treatment group, which received the CBD-rich cannabis extract, and the control group, which received the placebo. They both used their respective products for a period of 12 weeks. Statistical analysis was done by two-factor mixed analysis of variance (two-way ANOVA). Results Significant results were found for social interaction (F1,116 = 14.13, p = 0.0002), anxiety (F1,116 = 5.99, p = 0.016), psychomotor agitation (F1,116 = 9.22, p = 0.003), number of meals a day (F1,116 = 4.11, p = 0.04), and concentration (F1,48 = 6.75, p = 0.01), the last of which was only significant in mild ASD cases. Regarding safety, it was found that only three children in the treatment group (9.7%) had adverse effects, namely dizziness, insomnia, colic, and weight gain. Conclusion CBD-rich cannabis extract was found to improve one of the diagnostic criteria for ASD (social interaction), as well as features that often co-exist with ASD, and to have few serious adverse effects.

Medicina cannabinoide en el territorio orofacial: estado actual y perspectivas a futuro / Cannabinoid medicine in the orofacial region: status and prospects

Introducción: El interés por emplear cannabis y cannabinoides como herramienta terapéutica ha tomado relevancia en la medicina en los últimos años. En sintonía con ello en odontología se ha incrementado el interés por su estudio. El objetivo de la presente revisión narrativa fue analizar y sintetizar la información disponible acerca de las posibilidades terapéuticas actuales del cannabis en odontología y sus perspectivas futuras. Materiales y métodos: Se realizó una búsqueda electrónica que abarcó artículos hasta diciembre del 2022, en las bases de datos MEDLINE, Scopus, Scielo y Google Académico. Se utilizaron las siguientes palabras claves principales: "dental", "dentistry", "cannabis", "cannabinoids", "benefits", "therapeutics", "treatment", "potential". En las búsquedas iniciales se encontraron un total de 834 registros. Se evaluó la elegibilidad de 45 artículos de texto completo. Se incluyeron 35 estudios para el análisis cualitativo de la presente revisión. Resultados: Los estudios muestran gran variedad de cannabinoides y derivados empleados, preparados comerciales, así como preparados experimentales. Se han llevado adelante estudios in vitro, in vivo y clínicos que evalúan la acción de los cannabinoides en el control del dolor orofacial, de la inflamación, como cicatrizante, en la regeneración del tejido óseo, como antimicrobiano y su capacidad anticancerígena. Conclusiones: Los cannabinoides han demostrado potencial en el tratamiento de diversas condiciones y/o alteraciones bucales. Aún la estandarización de los productos y protocolos de tratamiento es insuficiente por los que son necesarios más estudios que evalúen presentaciones, derivados, métodos de extracción, concentraciones y vías de administración.

Introduction: The interest in using cannabis and cannabinoids as a therapeutic tool has gained relevance in medicine in recent years. In line with this, interest in its study has increased in dentistry. The aim of the present narrative review was to analyze and synthesize the available information about the current therapeutic possibilities of cannabis in dentistry and its future perspectives. Materials and methods: an electronic search conducted that included articles until December 2022, in the MEDLINE, Scopus, Scielo and Google Scholar databases. The following main keywords used: "dental," "dentistry," "cannabis," "cannabinoids," "benefits," "therapeutics," "treatment," "potential." A total of 834 records founded in the first searches. Forty-five full-text articles assessed for eligibility. Thirty-five studies included for the qualitative analysis of the present review. Results: Studies show a great variability of cannabinoids and derivatives used, including commercial preparations, as well as experimental preparations. In vitro, in vivo, and clinical studies had conducted evaluating the action of cannabinoids in the control of orofacial pain, as anti-inflammatory and healing, in bone tissue regeneration, as antimicrobial and evaluating their anti-cancer ability. Conclusions: Cannabinoids have shown potential in the treatment of various oral conditions and/or disorders. Even the standardization of products and treatment protocols is insufficient, which is why more studies are necessary to evaluate presentations, derivatives, extraction methods, concentrations, and routes of administration for their best use.

Use of cannabis and its derivates in chronic pain management: systematic review / Uso de cannabis e seus derivados no manejo da dor crônica: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain is a clinical condition that affects an important part of the Brazilian and world population, significantly affecting their lives. The medicinal properties of Cannabis have been explored for millennia, but recently its use for the relief of chronic pain symptoms has increased. CONTENTS: A systematic review was carried out with the objective of evaluating the use of cannabis and its derivatives in the management of chronic pain, analyzing its potential side effects and safety. For this, the following databases were used: Pubmed, Embase, Cochrane Library and BVS, searching for studies published in the last 5 years, in Portuguese, Spanish or English, using MeSH descriptors and relevant free terms. Randomized, double-blind clinical trials with at least 10 participants in each comparison arm and with at least 2 weeks of intervention were included. After screening the authors, a quantitative analysis of 4 clinical trials (586 patients) was performed, which were analyzed for the outcomes of: patients with 50% or 30% reduction in pain intensity compared to baseline, improvement in pain intensity average pain, discontinuation due to adverse effects, serious adverse effects, and any adverse effects. CONCLUSION: The analysis did not yield high-quality evidence pertaining to the evaluation of efficacy, safety, or adverse effects associated with the use of cannabis-derived treatments in the management of chronic pain. Consequently, the formulation of recommendations or restrictions in these regards is not feasible, leaving the utilization of these therapeutic modalities subject to individual assessment.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor crônica é uma condição clínica que atinge parte importante da população brasileira e mundial, afetando significativamente a vida dessas pessoas. As propriedades medicinais da Cannabis vêm sendo exploradas por milênios, mas recentemente seu uso para alívio dos sintomas da dor crônica tem aumentado. CONTEÚDO: Foi conduzida uma revisão sistemática com o objetivo de avaliar o uso de cannabis e seus derivados no manejo da dor crônica, analisando seus potenciais efeitos adversos e sua segurança. Para isso, foram utilizadas as seguintes bases de dados: PubMed, Embase, Cochrane Library e BVS, buscando estudos publicados nos últimos 5 anos, nos idiomas português, espanhol ou inglês, utilizando os descritores MeSH e termos livres relevantes. Foram incluídos ensaios clínicos randomizados, duplos-cegos, com pelo menos 10 participantes em cada braço de comparação e com no mínimo 2 semanas de intervenção. Após a triagem dos autores, foi procedida a análise quantitativa de 4 ensaios clínicos (586 pacientes), que foram analisados para os desfechos de: pacientes com redução da intensidade da dor 50% ou 30% em relação à linha de base, melhora na intensidade média da dor, descontinuidade devido a efeitos adversos, efeitos adversos graves e qualquer efeito adverso. CONCLUSÃO: Não foram encontradas evidências de alta qualidade quanto à avaliação dos desfechos de eficácia, segurança ou de efeitos adversos relacionados ao uso de tratamentos derivados da cannabis no manejo de dor crônica, não podendo ser produzidas recomendações ou restrições nesses aspectos, ficando o uso dessas modalidades terapêuticas sujeito a análise individual.

The association between the consumption of psychoactive substances and psychiatric disorders in polyconsumers at the Puebla Juvenile Integration Center

Abstract A retrospective, longitudinal study was conducted on 130 patients aged between 12 and 24 years, in accordance with the corresponding selection criteria and applying the ꭔ 2 statistical test and Fisher's exact test, with a confidence interval of 95% and a statistical significance of * p <0.05. The results obtained reveal that 119 (91.5%) patients from the sample group presented dual pathology, the majority of which were male, among whom marijuana was the most preferred psychoactive substance with 92.4%, followed by alcohol with 60.5%, amphetamines with 52.1%, and cocaine with 40.3%. The average age of the male subjects was 19.32 years ± 3.5. Nine subjects from (6.9%) the female population presented a possible dual pathology, with marijuana identified as the psychoactive substance of choice for 100% of this group, followed by amphetamines with 77.8%, alcohol with 55.6%, and cocaine with 33.3%, while the group's mean age was 18.44 years ± 4.30. The most statistically significant associations found were marijuana with depression (P *<0.0236), cocaine and amphetamines with anxiety and psychosis (P ***<0.0003 and ***<0.0001, respectively), and amphetamines and post-traumatic stress disorder (PTSD) (P *<0.0132) and the association between alcohol and attention deficit hyperactivity disorder (ADHD) (P **<0.0067).

Detección de sustancias psicoactivas ilegales en orinade madres y recién nacidos en un hospital público. Comparación de quinquenios 2009-2013 y 2014-2018 / Detection of illicit psychoactive substances in the urine of mothers and newborn infants at a public hospital. Comparison between the 2009­2013 and 2014­2018 five-year periods

Introducción. El consumo de sustancias psicoactivas ilegales en el embarazo constituye un problema creciente. En pocas maternidades latinoamericanas se aplica una estrategia de detección y los datos publicados son escasos. Objetivos. Comparar dos quinquenios de resultados de una estrategia de detección de sustancias psicoactivas ilegales implementada en el posparto. Población y métodos. Estudio de corte transversal. Detección por inmunoensayo en orinas de binomios madre-hijo/a, en un hospital público argentino entre 2009 y 2018. Resultados. En 76/191 binomios se detectaron sustancias en 10 años. El criterio de detección más frecuente fue la comunicación o antecedente de uso de drogas: 25/37 y 32/39 en cada quinquenio. Predominaron cannabis (21/37 y 26/39) y cocaína (19/37 y 16/39) en ambos períodos. No hubo diferencias en datos demográficos, ginecológicos, del embarazo ni neonatales en los quinquenios comparados. Conclusiones. No se encontraron diferencias en la frecuencia ni en el tipo de sustancias detectadas a lo largo de 10 años.

Introduction. The use of illicit psychoactive substances during pregnancy is a growing problem. Few Latin American maternity centers implement a screening strategy, and published data are scarce. Objectives. To compare the outcomes of 2 five-year periods of a postpartum strategy to screen for illicit psychoactive drugs. Population and methods. This was a cross-sectional study. Immunoassay detection in urine of mothernewborn infant dyads in an Argentine public hospital between 2009 and 2018. Results. Substances were detected in 76/191 dyads over 10 years. The most frequent detection criterion was reporting or history of drug use: 25/37 and 32/39 in each five-year period. Cannabis (21/37 and 26/39) and cocaine (19/37 and 16/39) predominated in both periods. No differences were observed in demographic, gynecological, pregnancy, or neonatal data between both five-year periods. Conclusions. No differences were found in the frequency or type of substances detected over 10 years

Beneficio clínico del tratamiento con cannabinoides para el dolor crónico no oncológico / Clinical benefit of cannabinoids to treat chronic non-cancer pain / Benefício clínico do tratamento com canabinoide para dor crônica não oncológica

Introducción: los cannabinoides pueden ser una opción válida para el tratamiento del dolor crónico no oncológico de acuerdo a los estudios publicados hasta el momento y a nuestra experiencia clínica. Objetivo: valorar el beneficio clínico de preparados de cannabis medicinal (CM) para dolor crónico no oncológico en pacientes que consultaron en la Clínica de Endocannabinología del Uruguay (CEDU). Material y método: estudio descriptivo, observacional, longitudinal, de una población atendida en un centro privado de salud. Se trata de una cohorte de 438 pacientes que consultaron espontáneamente en CEDU desde septiembre de 2016 a marzo de 2020. El motivo de consulta fue dolor crónico no oncológico que no respondió al tratamiento estándar. Resultados: en la cohorte estudiada predominaron las mujeres (74%), promedio 69 años, que se asisten en el sistema privado de salud en el 95% de los casos, en su mayoría con instrucción secundaria. El tipo de dolor más frecuente fue el dolor osteoarticular. El quimiotipo de CM más usado fue cannabidiol (CBD) al 5%, con buena respuesta al tratamiento en el descenso del nivel del dolor y suspensión o disminución de uso de opioides (y derivados) y antiinflamatorios no esteroideos (AINES). Se observaron escasos y leves efectos adversos (EA) en la gran mayoría de los pacientes. Abandonaron el tratamiento 12 pacientes (menos del 3%). Conclusiones: esta investigación retrospectiva mostró una caída del nivel del dolor de 3,14 (valor p ≤ 0,0001), indicando que el CM puede ser una opción para el tratamiento del dolor crónico no oncológico. Se requieren más estudios para demostrar la efectividad y seguridad de los cannabinoides. Esto depende de muchos factores (leyes que faciliten la accesibilidad a variedad de productos de CM de grado médico, incentivos a la ciencia e investigación). De todas formas, podemos afirmar que los resultados presentados son prometedores en relación con su potencial terapéutico.

Introduction: Cannabinoids can be a valid option for the treatment of chronic non-cancer pain, according to the studies published to date and our clinical experience. Objectives: To evaluate the clinical benefit of medicinal cannabis preparations (MCPs) for chronic non-cancer pain in patients seen at the Endocannabinology Clinic of Uruguay (CEDU). Method: Descriptive, observational, longitudinal study of a population treated at a private healthcare center. This involves a cohort of 438 patients who spontaneously consulted at CEDU from September 2016 to March 2020. The reason for consultation was chronic non-cancer pain that did not respond to standard treatment. Results: in the studied cohort, women prevailed and accounted for 74% of patients. Average age was 69 years old and 95% of them sought care within the private healthcare system. Most women had completed secondary school education. The most frequent type of pain was osteoarticular pain. The most used chemovar of Medicinal Cannabis (MC) was 5% cannabidiol (CBD), showing a favorable treatment response in reducing pain levels and the discontinuation or reduction of opioid and non-steroidal anti-inflammatory drug (NSAID) usage. Few and mild adverse effects (AE) were observed in the vast majority of patients. Twelve patients (less than 3%) discontinued the treatment. Conclusions: This retrospective study demonstrated a reduction in pain level of 3.14 (p-value ≤ 0.0001) indicating that MC could be an option for the treatment of non-oncological chronic pain. Further studies are needed to demonstrate the effectiveness and safety of cannabinoids. This depends on many factors (laws facilitating accessibility to a variety of medical-grade MC products, incentives for science and research). Nevertheless, we can assert that the presented results are promising in consideration of their therapeutic potential.

Introdução: os canabinoides podem ser uma opção válida para o tratamento da dor crônica não oncológica de acordo com estudos publicados até o momento e nossa experiência clínica. Objetivos: avaliar o benefício clínico das preparações de Cannabis Medicinal (CM) para dor crônica não oncológica em pacientes que consultaram a Clínica de Endocanabinologia do Uruguai (CEDU). Método: estudo descritivo, observacional, longitudinal de uma população atendida em um centro de saúde privado. Esta é uma coorte de 438 pacientes que consultaram espontaneamente no CEDU no período setembro de 2016 - março de 2020. O motivo da consulta foi dor crônica não oncológica que não respondeu ao tratamento padrão. Resultados: na coorte estudada, 74% eram mulheres, a idade média foi 69 anos, 95% frequentam a rede privada de saúde e a maioria com ensino médio. O tipo de dor mais frequente foi a osteoarticular. O quimiotipo de MC mais utilizado foi o Canabidiol 5% (CBD), com boa resposta ao tratamento em termos de redução do nível de dor e suspensão ou redução do uso de opioides (e derivados) e anti-inflamatórios não esteroides (AINEs). A grande maioria dos pacientes apresentou poucos e leves efeitos adversos (EAs). Menos de 3% dos 12 pacientes abandonou o tratamento. Conclusões: Esta investigação retrospectiva mostrou uma queda no nível de dor de 3,14 (valor de p ≤ 0,0001), indicando que o MC pode ser uma opção para o tratamento da dor crônica não oncológica. São necessários mais estudos para demonstrar a eficácia e segurança dos canabinoides. Isso depende de muitos fatores (leis que facilitem o acesso a uma variedade de produtos CM de grau médico, incentivos para ciência e pesquisa). De qualquer forma, podemos afirmar que os resultados apresentados são promissores em relação ao seu potencial terapêutico.

Factores pronósticos del deterioro cognitivo en pacientes adictos a sustancias psicoactivas / Prognostic factors of cognitive impairment in patients addicted to psychoactive substances

Introducción: Es importante considerar los daños que el consumo de sustancias psicoactivas produce al cerebro, para entender el pronóstico y la evolución del paciente, ya que puede causar deterioro cognitivo y llegar a la demencia. Objetivo: Determinar los factores pronósticos del deterioro cognitivo en pacientes adictos a sustancias psicoactivas. Método: Se desarrolló un estudio observacional, analítico y transversal. Se trabajó con los pacientes atendidos por consumos de sustancias, en un servicio de psicología, del año 2016 al 2019. Las variables estudiadas fueron: función ejecutiva, edad, ideación suicida, sexo, características clínicas del consumo, sustancia consumida, coeficiente intelectual, deterioro cognitivo, ansiedad, depresión y tiempo de consumo. Se utilizaron técnicas tanto de la estadística descriptiva, como de la estadística inferencial. Resultados: Se estudiaron 257 pacientes, con consumo fundamentalmente de alcohol y marihuana, edad promedio de 34 años, predominó el sexo masculino (89 por ciento) y una media de 17 años de consumo. El 47 por ciento de los pacientes presentó deterioro cognitivo leve y 9,34 por ciento deterioro cognitivo moderado. El deterioro cognitivo se asoció con tener tolerancia invertida (odd ratio - OR= 6,4), disfunción ejecutiva (OR= 4,2), depresión (OR= 4,1), ansiedad (OR= 2,4), consumir otras sustancias diferentes al alcohol (OR= 2,6), tener necesidad subjetiva de consumo (OR= 2,5), alterada capacidad de abstención (OR= 2,3) e ideación suicida (OR= 2,0). Conclusiones: Los factores pronósticos del deterioro cognitivo en los pacientes adictos son: tolerancia invertida, alteraciones ejecutivas, depresión, ansiedad, consumir otras drogas diferentes al alcohol, tener alterada la capacidad de abstención y presentar ideas suicidas(AU)

Introduction: It is important to consider the damage that the consumption of psychoactive substances produces to the brain, in order to understand the prognosis and evolution of the patient, since it can cause cognitive impairment and reach dementia. Objective: To determine the prognostic factors of cognitive impairment in patients addicted to psychoactive substances. Methods: An observational, analytical and cross-sectional study was developed. We worked with patients treated for substance use, in a psychology service, from 2016 to 2019. The variables studied were: executive function, age, suicidal ideation, sex, clinical characteristics of consumption, substance consumed, intelligence quotient, cognitive impairment, anxiety, depression and time of consumption. Both descriptive and inferential statistical techniques were used. Results: 257 patients were studied, with consumption mainly of alcohol and marijuana, average age of 34 years, predominantly male (89 percent) and an average of 17 years of consumption. 47 percent of the patients had mild cognitive impairment and 9.34 percent had moderate cognitive impairment. Cognitive impairment was associated with having inverted tolerance (odd ratio OR= 6.4), executive dysfunction (OR= 4.2), depression (OR= 4.1), anxiety (OR= 2.4), consuming substances other than alcohol (OR= 2.6), having subjective need for consumption (OR= 2.5), altered abstinence capacity (OR= 2.3) and suicidal ideation (OR= 2.0). Conclusions: The prognostic factors of cognitive impairment in addicted patients are: inverted tolerance, executive alterations, depression, anxiety, consuming drugs other than alcohol, having altered abstinence capacity and presenting suicidal ideation(AU)

Estudio comparativo del funcionamiento neuropsicológico y neurofisiológico en consumidores habituales de cannabis y controles sanos / Comparative study of neuropsychological and neurophysiological functioning in regular users of cannabis and healthy controls

Resumen El objetivo de este estudio es realizar un análisis comparativo del funcionamiento cognitivo de un grupo de consumidores de cannabis y controles sanos, mediante la aplicación de pruebas neuropsicológicas y potenciales relacionados con eventos mismatch negativity (MMN) y P3a en un EEG de 32 canales, y evaluar su asociación con características de consumo. La muestra estuvo conformada por 21 consumidores de cannabis (CN) y 22 controles sanos (SN) entre los 18 a 35 años. El grupo CN puntuó más alto en la lista de palabras IA de la WMS-III y el tiempo del Stroop parte A, mientras que el grupo SN presentó reducción en la amplitud de P3a en F3, C3 y FCZ y mayor latencia en F4. En relación a las características de consumo, la abstinencia al cannabis presentó una correlación fuerte con el porcentaje de retención en la memoria verbal, la latencia del MMNd/P3a en C4 y la amplitud de la P3a en F3, mientras que el número de cigarrillos de cannabis presentó una correlación fuerte con la latencia de P3a en FCZ. En conclusión, nuestros hallazgos corroboran la presencia de alteraciones específicas. Se destaca la P3a como posible marcador neurofisiológico en investigación clínica y traslacional en esta población.

Abstract The objective of this study is to perform a comparative analysis of the cognitive functioning of a group of cannabis users and healthy controls, by applying neuropsychological tests and potential events related to mismatch negativity (MMN) and P3a in a 32-channel EEG, and evaluate its association with consumption characteristics. The sample consisted of 21 cannabis users (CN) and 22 healthy controls (SN) between 18 and 35 years old. The CN group scored higher on the WMS-III IA word list and Stroop time part A, while the SN group had reduced P3a amplitude in F3, C3, and FCZ and higher latency in F4. In relation to the characteristics of consumption, abstinence from cannabis presented a strong correlation with the percentage of retention in verbal memory, the latency of MMNd/P3a in C4 and the amplitude of P3a in F3, while the number of cannabis cigarettes presented a strong correlation with the latency of P3a in FCZ. In conclusion, our findings corroborate the presence of specific alterations. P3a stands out as a possible neurophysiological marker in clinical and translational research in this population.

Motivos para el consumo de tabaco, alcohol y cannabis en el contexto del confinamiento por COVID-19 / Motives for tobacco, alcohol, and cannabis use in the confinement context due to COVID-19 pandemic

Introducción. Las drogas producen importantes consecuencias negativas en las sociedades. La prevalencia de su consumo sigue aumentando debido a que existen diversos motivos que acercan a las personas a consumirlas. Objetivo. Identificar las diferencias en la frecuencia y cantidad del consumo de tabaco, alcohol y cannabis durante y después del confinamiento por la pandemia de COVID-19; así como la influencia del confinamiento en los motivos y los riesgos de desarrollar un consumo problemático. Metodología. Estudio transversal analítico con muestreo no probabilístico en dos momentos. Participaron 520 jóvenes: 246 estudiantes de bachillerato y universidad en el año 2020, durante el confinamiento y 274, en 2022. Se evaluaron datos sociodemográficos, motivos de consumo y consumo problemático. Resultados. El consumo de cannabis durante el confinamiento (41,1 %) fue mayor que en el posconfinamiento (29,6 %; p 0,006). Hubo diferencias entre los grupos de consumo problemático de tabaco durante el confinamiento y los motivos sociales (W 8,178, p 0,017) y de afrontamiento (W 26,456, p < 0,001); también, entre los grupos de consumo problemático de alcohol y los motivos sociales (W 6865,5, p < 0,001); de animación (W 6768,0, p < 0,001); de afrontamiento (W 6176,0, p = 0,002) y de expansión (W 6774,0, p < 0,001). Entre los motivos del consumo problemático de cannabis se destacan los sociales (W 6,404, p 0,041); de animación (W 9,409, p 0,009); de afrontamiento (W 9,265, p 0,010) y de expansión (W 27,692, p < 0,001). Conclusión. El confinamiento incrementó el riesgo de consumir tabaco y cannabis. Los motivos de consumo también aumentaron, excepto las asociadas al consumo de alcohol en universitarios. El consumo problemático de tabaco estuvo motivado por necesidades sociales y de afrontamiento; el de alcohol y cannabis, por necesidades sociales, de animación, de afrontamiento y de expansión

Introduction. Drugs produce significant negative consequences in societies. The prevalence of drug use continues to increase because various reasons lead people to use them. Objective. Identify differences in the frequency and amount of tobacco, alcohol, and cannabis use during and after COVID-19 pandemic confinement, the influence of confinement on motives, and risks for developing problematic use. Methodology. Analytical cross-sectional study with non-probabilistic sampling at two points in time. Five hundred and twenty young people participated: 246 high school and university students during the confinement in 2020, and 274 in 2022. Sociodemographic data, reasons for consumption, and problematic consumption were evaluated. Results. Cannabis use during confinement (41.1 %) was higher than post-confinement (29.6 %; p 0.006). There were differences between the groups of problematic tobacco use during confinement and the social (W 8.178, p 0.017), and coping (W 26.456, p < 0.001) motives; also, between the groups of problematic alcohol consumption and social motives (W 6865.5, p < 0.001); encouragement (W 6768.0, p < 0.001); coping (W 6176.0, p = 0.002) and expansion (W 6774.0, p < 0.001). Among the motives for problematic cannabis use, social (W 6.404, p 0.041); animation (W 9.409, p 0.009); coping (W 9.265, p 0.010), and expansion (W 27.692, p < 0.001) were highlighted. Conclusion.Confinement increased the risk of tobacco and cannabis use. Motives for use also increased, except those associated with alcohol use in university students. Problem tobacco use was motivated by social and coping needs; alcohol and cannabis use was motivated by social, entertainment, coping and expansion needs

Biomasa residual de industria del Cannabis, una alternativa para la obtención de productos de alto valor agregado

A medida que como sociedad vamos dando más importancia a lograr una economía circular, se hace importante encontrar fuentes renovables aptas para la producción de biocombustibles y bioquímicos. En los últimos años, diversas fuentes de biomasa lignocelulósica han sido estudiadas para estos propósitos. Dentro de estas fuentes de biomasa se encuentra el cáñamo (Cannabis sativa L.), siendo parte de una industria que ha crecido a pasos agigantados en las últimas décadas, en Colombia, desde su legalización. Específicamente, la industria del cannabis medicinal es responsable de generar una enorme cantidad de residuos en forma de los tallos de la planta, considerados un subproducto de bajo valor. En esta revisión se compila la información de diferentes estudios sobre el aprovechamiento de la fracción de polisacáridos de biomasa cáñamo, mediante transformaciones químicas y bioquímicas, para la obtención de productos de valor agregado. Se encontró que la mayoría de estudios están enfocados en la obtención de bioetanol o biogás; se encontraron también reportes de otras moléculas como ácido succínico, ácido láctico, furfural, polihidroxialcanoatos y bisaboleno. La viabilidad a nivel industrial de todos estos procesos permanece siendo una incógnita, pues los pasos de pretratamiento, hidrólisis y de conversión final utilizados suelen ser costosos. Es necesario que los estudios que realicen en el futuro se enfoquen en optimizar las condiciones de estos procesos y hacerlos verdes y así asegurar que puedan ser escalados.

As we as a society, give more importance to achieving a circular economy, it becomes important to find renewable sources suitable for the production of biofuels and biochemicals. In the last years, several different sources of lignocellulosic biomass have been studied for these purposes. One of these biomass sources is hemp (Cannabis sativa L), being part of an industry that has grown through giant steps in the last decades, in Colombia, since its legalization. Specifically, the industry of medicinal hemp is responsible for the generation of huge amounts of residues in the form of the plant stalks, considered a low value subproduct. This review compiles the information of several studies about the exploitation of the polysaccharide portion of hemp biomass through chemical and biochemical transformations, obtaining value-added products. It was found that most of these studies focus on the production of bioetanol or biogas; reports of other molecules such as succinic acid, furfural, polyhydroxyalkanoates and bisabolene were also found. Industrial viability of these processes remains a question, since pretreatment, hydrolysis and final conversion steps are usually expensive. It necessary that future studies focus on optimizing conditions of these processes as well as making them green, ensuring that they can be scaled.

Cannabis: Drug of Abuse and Therapeutic Agent, Two Sides of the Same Coin

ABSTRACT The consumption of Cannabis sativa plant, known as marijuana in the Western world, for different purposes (therapeutic, intoxicating, and spiritual) due to its psychoactive effects, can be traced back to ancient times. Cannabis is the most used illicit drug worldwide; however, its legal status is changing rapidly. Cannabis regulation will allow a better understanding of its effects as a misused drug, including new challenges, such as the availability of highly potent Cannabis extracts. Furthermore, scientific research is making significant efforts to take advantage of the potential therapeutic uses of Cannabis active compounds. The science of Cannabis derivatives started with the identification of the phytocannabinoids Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD), allowing the formal study of the complex set of effects triggered by Cannabis consumption and the deciphering of its pharmacology. Δ9-THC is recognized as the compound responsible for the psychoactive and intoxicating effects of Cannabis. Its study led to the discovery of the endocannabinoid system, a neuromodulatory system widespread in the human body. CBD does not induce intoxication and for that reason, it is the focus of the search for cannabinoid potential clinical applications. This review examines the current state of knowledge about contrasting perspectives on the effects of Cannabis, Δ9-THC, and CBD: their abuse liability and potential therapeutic use; two sides of the same coin.

El cannabis como agente terapéutico en Ecuador, repercusión económica contable

El panorama salubrista ecuatoriano se enfrenta a la introducción, como producto legalizado, del cannabis como agente terapéutico en el país. Esta medida trae consigo una serie de transformaciones en varios aspectos a los que la vida productiva del país debe de adaptarse de forma acelerada. El objetivo de esta investigación fue analizar la posible repercusión económica contable que trae la legalización del cannabis como recurso terapéutico. Se desarrollo una revisión bibliográfica y análisis posterior para poder realizar un modelo futurista de como la introducción del cannabis influenciará el mercado productivo y contable en el país. Se considera que la introducción en el mercado farmacéutico de productos derivados de cannabis, para uso medicinal, será inicialmente importado; sin embargo, con el de cursar del tiempo se irán implementando otras acciones como la siembra, recolección, procesamiento, distribución y venta de producto final. Todos estos elementos generaran empleos, gastos, ingresos, inversiones y otros elementos que implican una repercusión económica y contable en el país. Se concluye que la perspectiva futura, desde el punto de vista económica y contable, con la legalización del cannabis como agente terapéutico en el país, es favorable; sin embargo, para lograrlo es necesario que se autoricen otros procesos previos a la comercialización de productos farmacéuticos basados en las propiedades del cannabis; solo de esa forma se podrá precisar su influencia en el mercado laboral y económico del Ecuador.

The Ecuadorian health scene is facing the introduction, as a legalized product, of cannabis as a therapeutic agent in the country. This measure brings with it a series of transformations in various aspects to which the productive life of the country must adapt rapidly. The objective of this research is to analyze the possible accounting economic repercussion that the legalization of cannabis brings as a therapeutic resource. A bibliographical review and subsequent analysis were carried out in order to carry out a futuristic model of how the introduction of cannabis will influence the productive and accounting market in the country. It is considered that the introduction into the pharmaceutical market of products derived from cannabis, for medicinal use, will initially be imported; however, with the passage of time, other actions will be implemented such as planting, harvesting, processing, distribution and sale of the final product. All these elements will generate jobs, expenses, income, investments and other elements that imply an economic and accounting repercussion in the country. It is concluded that the future perspective, from the economic and accounting point of view, with the legalization of cannabis as a therapeutic agent in the country, is favorable; However, to achieve this, it is necessary to authorize other processes prior to the commercialization of pharmaceutical products based on the properties of cannabis; Only in this way can its influence on the labor and economic market of Ecuador be specified.